Refiguring the social? Health insurance for the poor in Kenya
Across the globe, current moves towards Universal Health Coverage (UHC) appear to extend ‘the social’. Reviving a language of fairness and social justice, solidarity and human rights, UHC promises to ensure access to quality healthcare for all ‘without financial hardship’. In Africa, moves towards UHC involve experimentation with progressive policies of expanding state responsibility for healthcare and social protection for citizens. However, they also occur amidst continual expansion of private healthcare and growing social inequality. Indeed, UHC can easily be dismissed as a sticking plaster solution that merely reproduces neoliberal forms of governance and healthcare reform, offering minimal forms of financial protection and healthcare for targeted beneficiaries such as ‘the poor’.
Our research aims to move beyond the impasse between endorsement and critique to take seriously the aspirations and interpretations of actors, and the translations and frictions involved in moves towards expanding access to health care for ‘all’. In this vein, Professor Prince’s presentation will follow the Kenyan government’s recent attempts to expand health insurance for its citizens. She draws upon ethnographic research conducted in several periods from 2018 to the present with actors involved in the design and implementation of these schemes, as well as with ordinary Kenyans struggling to access healthcare. In doing so she explores relations between policy design and implementation as actors struggle with a spectrum of complexities, from locating ‘the poor’ to digital registration, to ensuring financial flows and the delivery of medicine.
Ruth Prince is Professor of Medical Anthropology at the University of Oslo. She leads a European Research Council Starting Grant project, ‘Universal Health Coverage and the Public Good in Africa: Anthropological Perspectives’, which explores relations between health care, citizenship and the state, and between formal and informal forms of welfare and social solidarity. She is currently studying Kenya’s experiments with universal health coverage and health insurance markets, social networks of care, and class relations.
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